Primary Prevention of Cardiovascular Disease at Community Clinics in the State of Sao Paulo, Brazil: Results from the Epidemiological Information Study of Communities

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art_FONSECA_Primary_Prevention_of_Cardiovascular_Disease_at_Community_Clinics_2023.PDF (1.02 MB)
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0
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
UBIQUITY PRESS LTD
Autores
FONSECA, Henrique Andrade R.
IZAR, Maria cristina O.
PINTO, Ibraim M.
FERREIRA, Joao Fernando Monteiro
AVEZUM, Alvaro
FONSECA, Francisco Antonio
BERWANGER, Otavio
Citação
GLOBAL HEART, v.18, n.1, article ID 1203, 12p, 2023
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Background: Primary prevention of cardiovascular disease (CVD) remains a major challenge, especially in communities of low-and middle-income countries with poor medical assistance influenced by distinct local, financial, infrastructural, and resource -related factors. Objective: This a community-based study aimed to determine the proportion and prevalence of uncontrolled cardiovascular risk factors (CRF) in Brazilian communities. Methods: The EPICO study was an observational, cross-sectional, and community clinic-based study. Subjects were living in Brazilian communities and were of both sexes and & GE;18 years old, without a history of a stroke or myocardial infarction but presenting at least one of the following cardiovascular risk factors: hypertension, diabetes mellitus and hypercholesterolemia. The study was carried out in Brazil, including 322 basic health units (BHU) in 32 cities. Results: A total of 7,724 subjects with at least one CRF were evaluated, and one clinical visit was performed. Mean age was 59.2 years-old (53.7% were >60 years old). A total of 66.7% were women. Of the total, 96.2% had hypertension, 78.8% had diabetes mellitus type II, 71.1% had dyslipidemia, and 76.6% of patients were overweight/obese. Controlled hypertension (defined by <130/80 mmHg or <140/90 mmHg) was observed in 34.9% and 55.5% patients among respective criteria, the rates of controlled blood glucose in patients taking antidiabetic medications was 29.5%, and among those with documented dyslipidemia who received any lipid-lowering medication, only 13.9% had LDL-c on target. For patients presenting three CRF less than 1.9% had LDL-c < 100 mg/dL once their BP and blood glucose were on target. High education level as associated with blood pressure (BP) target of less than 130 / 80mm Hg. The glucose and LDL-c levels on target were associated with the presence of hypertension and diabetes mellitus. Conclusion: In Brazilian community clinics, regarding most patients in primary prevention, the CRF such as BP, blood glucose, and lipid levels are poorly controlled, with a majority of patients not achieving guidelines/recommendations.
Palavras-chave
hypertension, diabetes mellitus, dyslipidemia, primary cardiovascular prevention, health communities
URI
https://observatorio.fm.usp.br/handle/OPI/55975
Referências
  1. Akanbi MO, 2019, ADDICTION, V114, P620, DOI 10.1111/add.14518
  2. Arnett DK, 2019, CIRCULATION, V140, pE596, DOI [10.1161/CIR.0000000000000677, 10.1161/CIR.0000000000000678, 10.1016/j.jacc.2019.03.010, 10.1016/j.jacc.2019.03.009]
  3. Banegas JR, 2011, EUR HEART J, V32, P2143, DOI 10.1093/eurheartj/ehr080
  4. Barbaresko J, 2018, AM J PREV MED, V55, P555, DOI 10.1016/j.amepre.2018.04.046
  5. Blom DJ, 2020, EUR J PREV CARDIOL, V27, P1403, DOI 10.1177/2047487319871735
  6. Chomistek AK, 2015, J AM COLL CARDIOL, V65, P43, DOI 10.1016/j.jacc.2014.10.024
  7. Coutinho DF, 2021, PHARMACOEPIDEM DR S, V30, P749, DOI 10.1002/pds.5236
  8. Dixon DL, 2019, J AM COLL CARDIOL, V74, P1728, DOI 10.1016/j.jacc.2019.08.014
  9. Ettehad D, 2016, LANCET, V387, P957, DOI 10.1016/S0140-6736(15)01225-8
  10. Faludi AA, 2017, ARQ BRAS CARDIOL, V109, P1, DOI 10.5935/abc.20170188
  11. Fernandes LCL, 2009, REV SAUDE PUBL, V43, P595, DOI 10.1590/S0034-89102009005000040
  12. FRIEDEWALD WT, 1972, CLIN CHEM, V18, P499
  13. Gooding HC, 2020, J AM HEART ASSOC, V9, DOI 10.1161/JAHA.120.016115
  14. International diabetes federation, 2012, CLIN GUID TASK FORC
  15. Kotseva K, 2021, EUR J PREV CARDIOL, V28, P370, DOI 10.1177/2047487320908698
  16. Lopes RD, 2018, AM HEART J, V205, P154, DOI 10.1016/j.ahj.2018.08.012
  17. Mach F, 2019, ATHEROSCLEROSIS, V290, P140, DOI [10.1093/eurheartj/ehz455, 10.1016/j.atherosclerosis.2019.08.014]
  18. Nelson AJ, 2021, CIRCULATION, V144, P74, DOI 10.1161/CIRCULATIONAHA.121.053766
  19. Piepoli MF, 2016, EUR HEART J, V37, P2315, DOI 10.1093/eurheartj/ehw106
  20. Precoma DB, 2019, ARQ BRAS CARDIOL, V113, P787, DOI 10.5935/abc.20190204
  21. Santos RD, 2021, ARQ BRAS CARDIOL, V116, P706, DOI 10.36660/abc.20190516
  22. Schwalm JD, 2019, LANCET, V394, P1231, DOI 10.1016/S0140-6736(19)31949-X
  23. Thomopoulos C, 2014, J HYPERTENS, V32, P2285, DOI 10.1097/HJH.0000000000000378
  24. Unger T, 2020, J HYPERTENS, V38, P982, DOI [10.1097/HJH.0000000000002453, 10.1161/HYPERTENSIONAHA.120.15026]
  25. Vallejo-Vaz AJ, 2017, CIRCULATION, V136, P1878, DOI 10.1161/CIRCULATIONAHA.117.027966
  26. Mendes ABV, 2010, ACTA DIABETOL, V47, P137, DOI 10.1007/s00592-009-0138-z
  27. Viana LV, 2013, BMJ OPEN, V3, DOI 10.1136/bmjopen-2013-003336
  28. Walli-Attaei M, 2020, LANCET, V396, P97, DOI 10.1016/S0140-6736(20)30543-2
  29. WHO Expert Committee, 1991, Technical Report Series - World Health Organization
  30. Williams B, 2018, EUR HEART J, V39, P3021, DOI 10.1093/eurheartj/ehy339
  31. Wright JT, 2015, NEW ENGL J MED, V373, P2103, DOI 10.1056/NEJMoa1511939

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/63
Artigos e Materiais de Revistas Científicas - ODS/03